
                         Roanoke Times
                 Copyright (c) 1995, Landmark Communications, Inc.

DATE: MONDAY, March 30, 1992                   TAG: 9203300193
SECTION: EDITORIAL                    PAGE: A-11   EDITION: METRO 
SOURCE: PHYLLIS C. MARSTILLER
DATELINE:                                 LENGTH: Medium

REMISSION'S THE KEY

OVER THE PAST several weeks, considerable media attention has been given to the issue of autologous bone-marrow-transplant treatment for various types of diseases, and how Blue Cross and Blue Shield of Virginia considers this treatment in its coverage plans.

Some clarification is required as considerable misinformation has been circulated.

First, Blue Cross and Blue Shield of Virginia willingly pays for ABMT treatments for the following diseases: lymphoma, Hodgkin's disease, certain forms of leukemia, an uncommon cancer in children called neuroblastoma, and germ-cell tumors of the ovary and testis.

In many cases, our policy to cover this treatment for the above-mentioned diseases was several years ahead of Medicare and Champus, and enabled many Virginia citizens to have their ABMT treatment paid for by Blue Cross and Blue Shield of Virginia at an earlier phase of their illness, thus improving their chances for recovery.

In the case of Hodgkin's disease, our company pays for ABMT for patients who have gone into remission but have a high likelihood of recurrence.

It is important to understand that there are two phases of ABMT: the harvest of the bone marrow, which is followed by a treatment of high-dose chemotherapy and subsequent transplant of the harvested bone marrow back into the patient. The harvest can be done before remission, but the accepted medical practice requires remission from the disease before the transplant is performed.

Blue Cross and Blue Shield of Virginia has paid for dozens of ABMT treatments for Hodgkin's disease. In fact, we have never denied a claim for the treatment once it was determined by the patient's doctor that remission had occurred and the doctor had recommended ABMT.

This fact applies to the most recent Hodgkin's disease patient who received so much attention in the Roanoke Valley. Had he gone into remission and his doctor had recommended ABMT for him, Blue Cross and Blue Shield of Virginia would have paid that claim. Neither occurred. His doctor never indicated he had gone into remission, and his doctor never recommended the complete ABMT treatment for his patient.

In every case involving ABMT as an option, the cost of the treatment is not a consideration in whether the claim will be paid. Our record of paying for the treatment over the years is testimony to our willingness to cover treatment that is safe, effective and in accordance with established medical protocol.

Phyllis C. Marstiller of Richmond is president and chief operating officer of Blue Cross and Blue Shield of Virginia.

by CNB